Grants and Fellowships | 2014

22 Multi-Year Research Grants Chronic Exposure to Air Pollution and Long-Term Outcomes after First Acute Myocardial Infarction: A Population-Based Cohort Study Background: Epidemiological studies have provided broad evidence of the association between exposure to air pollution and cardiovascular disease (CVD) events. Long-term exposure to air pollution has been associated with progression of atherosclerosis, the underlying cause of CVD. Particulate air pollution appears to be the pollutant most consistently associated with adverse health outcomes, although associations have been reported also for NO 2 and traffic-generated pollutants. Preliminary data suggest that patients with myocardial infarction (MI) may be particularly vulnerable to the effects of chronic exposure to air pollution. However, methodological limitations inherent in the current literature, in addition to conflicting results, challenge these findings. Objectives: Using a historical prospective study, we aimed to evaluate the associations of chronic exposure to air pollutants with the occurrence of clinical outcomes after MI during long-term follow-up; to assess the incremental value of air pollution exposure over individual-level demographic, socioeconomic, clinical variables, and neighborhood- level SES, in predicting morbidity and mortality post-MI. We hypothesized that chronic exposure to air pollutants would be independently associated with long-term adverse post-MI outcomes. Major conclusions, solutions and achievements: A model assessing risk from chronic exposure to air pollutants was developed. High background levels of fine particulate matter (PM 2.5 ) were detected in central Israel, surpassing international guidelines. Furthermore, our findings demonstrate that chronic exposure to PM 2.5 has serious adverse health effects in post-MI patients in central Israel, increasing the risk of mortality and cardiovascular events. Implications for environment and health in Israel: The results of this research provide evidence of the adverse health effects of elevated PM 2.5 levels in central Israel in heart patients. Study findings are based on high-quality data from a well-defined MI cohort with extensive information on various confounding factors, sufficient follow-up period, and multiple outcomes assessed longitudinally. Steps need to be taken to reduce the public health threat of PM pollution. Research publications (1) Gerber, Y., Myers, V., Broday, D.M., Koton, S., Steinberg, D.M., & Drory, Y. (2010). Cumulative exposure to air pollution and long term outcomes after first acute myocardial infarction: A population-based cohort study. Objectives and methodology. BMC Public Health, 10 , 369. (2) Koton, S., Molshatzki, N., Yuval, Myers, V., Broday, D.M., Drory, Y., et al. (2013). Cumulative exposure to particulate matter air pollution and long-term post-myocardial infarction outcomes. Preventive Medicine, 57 (4), 339-344. Yariv Gerber 1 | Silvia Koton 1 David Broday 2 David. M. Steinberg 1 Yaacov Drory (deceased) 1 1. Tel Aviv University 2. Technion - Israel Institute of Technology 2009-2012